Pain And Inflammation

Question 1

Explain pain and inflammation perception?

Answer 1

Pain receptors known as nociceptors are sensory receptors that carries stimuli from tissue damage to the spinal cord.
Tissue damage or injury results in the release of chemical pain mediators such as prostaglandins,leukotrienes, bradykinns, substance P.
Analgesics are drugs that are used to manage pain resulting from inflammation in response to tissue damage (nociceptive pain) or nerve damage (neuropathic pain).

Question 2

What are the anagelsic according to the world health organization ladder ?

Answer 2

Non-opoids or Non narcotic anagelsics: e.g paracetamol (acetaminophen), aspirin (acetylsalicylic acid), piroxicam (oxicams)
Compound analgesics: e.g co-codamol( codeine 8mg and paracetamol 500mg) , co-dydramol, co-codaprin(codeine 8mg and aspirin 400mg)
Opoid or nacrotic analgesics: e.g morphine, codeine, tramadol, phenthaline, heroine.

Question 3

What are Non-opoids anagelsics and their side effects and MOA?

Answer 3

This drugs have anagelsics, antipyretic and anti-inflammatory properties. They are called NSAIDS: non- steriodal anti-inflammatory drugs. They are used for mild - moderate pains
They act by reducing the levels of chemical mediators produced during inflammation. They inhibit the enyme cyclo-oxygenase which is essential in synthesis of chemical mediators.

Question 4

Give short notes on 2 types of Non-opoids analgesics?

Answer 4

Paracetamol
It is most widely used pain relieving medication. It has mainly antipyretic effect and anagelsics properties. It does not have anti-inflammatory effect. A side effect is that if it used in high concentrations it can cause hepatotoxicity at very high doses.
Aspirin
It has inflammatory effect because it prevents thromboxane production by inhibiting course-2 enzymes. It is also used as an antiplatelet drug in cardiovascular disorders. It has side effects such as Indigestion, nausea, vomiting,rashes.

Question 5

What are the contraindications for using NSAIDS?

Answer 5

It shouldn’t be used in elders, people with diabetes, asthma and impaired renal or cardiac function.
It shouldn’t be used for people with previous history of adverse reaction such as peptic ulcers, clotting disorders.

Question 6

What are compound anagelsics and their side effects?

Answer 6

This anagelsics are the combination of drugs in a single tablet usually a weak opiate and NSAIDS. This class of drug require prescription. The side effects are Nausea, vomiting, drowsiness. They are used for mild - moderate pain.

Question 7

What are opoid anagelsics and their MOA, side effects?

Answer 7

This medication are the strongest and most effective pain killers they are obtained from morphine.
They act by binding to the opoids receptors in the CNS thereby stopping the passage of neurotransmitters across the nerve synapse which blocks pain experience. The side effects are drowsiness, dizziness, reduced libido, infertility.

Question 8

NOTE

Answer 8

Naloxone can be used to reverse the effects of opoids and treat nacrotic overdose. Prolonged use of nacrotics can result to in, physiological dependance and sometimes abuse.

Question 9

Topical Analgesics

Answer 9

These anagelsics provides localized pain relief and are used to treat acute and chronic pain such as musculoskeletal and neuropathic pain. They have low level of systemic absorption which reduces the risk of side effects. E.g topical NSAIDs.